公共卫生研究摘要 (2026-05-04)

共收录 57 篇研究文章

1. Lactic acid bacteria and endogenous ethanol mediate proton pump inhibitor-associated MASLD: a multicohort cross-sectional mediation analysis.

期刊: Gut microbes 发表日期: 2026-Dec-31 链接: PubMed

摘要

Proton pump inhibitor (PPI) use has been associated with metabolic dysfunction associated with steatotic liver disease (MASLD) in multiple studies. While the association is confounded by various risk factors, such as BMI and age, a potential mediating factor of the microbiome has been suggested. In this study, we aimed to identify bacterial clades with the highest mediating potential and evaluate the serially mediated path through microbially derived endogenous ethanol. Microbiome mediation analysis of PPI use and MASLD was conducted in two cohorts. In a bariatric surgery cohort (n = 122), liver biopsy-proven steatosis grade and postprandial ethanol concentrations were used as outcomes. In the HELIUS cohort (n = 2440), a general population cohort study, mediation was performed using the Fatty Liver Index (FLI) score. The strongest associations were validated in the FINRISK cohort (n = 7066). Several bacterial taxa, which are predominantly found in the small intestine, showed a potential role in mediating the effects of PPIs on MASLD, postprandial ethanol levels, and FLI score. The Lactobacillales order showed the strongest mediating potential across the outcomes tested in both discovery cohorts. A notable serial mediation pathway was identified, linking PPI use to MASLD via Lactobacillales abundance and postprandial plasma ethanol concentrations. The mediating role of Lactobacillales in the association between PPI use and FLI scores was confirmed in the final study cohort. Data from multiple cross-sectional cohort studies support a mediating potential of the microbiome in the association between PPI use and hepatic steatosis, independent of alcohol consumption. The effect of PPIs on MASLD appears to be mediated mainly by increased lactic acid bacteria abundance, and is potentially, in part, serially mediated by endogenous ethanol production.

2. From Using AI to Relating Through AI: A Postphenomenological and Reflexive Inquiry Into Nursing Education in Developing Country Contexts.

期刊: Nursing philosophy : an international journal for healthcare professionals 发表日期: 2026-Jul 链接: PubMed

摘要

Artificial intelligence (AI) technologies are increasingly integrated into nursing education often framed as neutral tools that enhance learning efficiency, consistency, and clinical decision-making. However, this instrumental framing obscures how AI may fundamentally reshape nursing students’ perception, ethical orientation, and professional formation, particularly in developing country contexts. Nursing training in developing countries is often characterised by infrastructural constraint and epistemic inequality compared to developed countries. This paper offers a conceptual-theoretical analysis of AI in nursing education with a focus on how it mediates the ways nursing students come to see, interpret, and relate to patients and clinical knowledge. Drawing on postphenomenology and a reflexive decolonial stance, the paper conceptualises AI as a mediating force. The analysis is structured around four modes of technological mediation (embodiment, hermeneutic, alterity, and background relations) to examine how AI reshapes embodied clinical practice, interpretive frameworks, pedagogical authority, and the hidden curriculum of nursing education in developing country settings. Reflexive attention to moments of critical friction reveals tensions between the standardised logic embedded in AI systems and the situated, relational realities of nursing education. The paper argues that AI mediates not only what nursing students know, but how they learn to attend, judge, and assume ethical responsibility. By foregrounding mediation and epistemic justice, it calls for more reflexive, context-sensitive approaches to integrating AI in global nursing education.

3. ChatGPT in Public Cardiovascular Healthcare: Accuracy, Limitations, and Implications.

期刊: Journal of evaluation in clinical practice 发表日期: 2026-Jun 链接: PubMed

摘要

ChatGPT is a cost-effective artificial intelligence (AI) tool designed to facilitate virtual interactions with humans, and its application in healthcare is expanding. However, research on ChatGPT’s effectiveness in public healthcare, particularly for cardiac patients, is still limited. This study aims to evaluate ChatGPT’s potential in managing cardiovascular health for patients with acute or chronic cardiac conditions. We analyzed real medical records from ‘The Cardiovascular Care’ program, affiliated with a university outpatient clinic. ChatGPT’s performance was evaluated in terms of its ability to analyze clinical cases, propose diagnoses, and recommend appropriate actions. We also assessed whether ChatGPT’s accuracy and errors varied depending on disease severity, rarity, mortality risk, and urgency. When compared to physicians’ records, ChatGPT provided correct responses in 43% of diagnostic hypotheses, 5% of recommended supplementary exams, and 10% of laboratory tests. It showed significant accuracy and discernment in diagnosing conditions influenced by factors such as severity, rarity, risk of death, and urgency. However, this discernment did not extend to recommendations for supplementary exams and laboratory tests. Interestingly, while ChatGPT’s responses in these areas were often only partially accurate, they tended to be more detailed, sometimes unnecessarily so, than those provided by physicians. Diagnostic hypotheses from multiple models, including ChatGPT Health, DeepSeek, Gemini Pro, Perplexity AI, and ESC Chat, were also evaluated. Performance varied across models, with ChatGPT demonstrating the highest diagnostic accuracy among those assessed, despite still producing incorrect outputs. Although ChatGPT demonstrates some diagnostic capability, its overall reliability remains questionable, with performance at times approaching random chance. Caution is advised when considering its use in clinical decision-making.

4. Re-Adaptation Experiences of Nurses Returning to Clinical Practice After Postgraduate Study: A Qualitative Study.

期刊: Journal of evaluation in clinical practice 发表日期: 2026-Jun 链接: PubMed

摘要

The reintegration of highly educated nurses into clinical practice represents a critical challenge in global healthcare workforce management. This study explored the re-adaptation experiences of clinical nurses who returned to practice after leaving their positions to pursue postgraduate education, to inform effective support strategies. A phenomenological study was conducted through semi-structured interviews with nine master’s-prepared nurses from two tertiary hospitals in Jiangxi Province (Feb-Mar 2025). Data were analysed using Colaizzi’s seven-step method. Motivations for return included balancing ideals with reality, career advancement, and policy influences. Common barriers were role conflict, skill gaps, and workplace pressure, while institutional support and self-development facilitated reintegration. Nurses successfully adapted by integrating their new roles, seeking support, and self-adjusting. The re-adaptation process is complex and multifaceted. We recommend that hospitals establish dual clinical-research career tracks and refine tiered employment mechanisms to enhance professional identity and job fit.

5. Healthcare Utilization and Recovery Duration After Ankle Fracture: A Claims-Based Study of Timeline, Costs and Complications.

期刊: Journal of evaluation in clinical practice 发表日期: 2026-Jun 链接: PubMed

摘要

Ankle fractures are common orthopaedic injuries with wide variability in recovery duration and outcome. While long-term outcomes are well documented, less is known about the short-term recovery period. An updated analysis using claims data would provide greater clarity on short-term recovery patterns. The study aimed to characterise recovery duration after treatment for ankle fracture and to evaluate associations between comorbidities, perioperative complications, additional procedures and healthcare costs. Healthcare claims from the IBM MarketScan database (2015-2018) were analysed to determine recovery costs for the index treatment and subsequent events including revision surgery, motion restoring surgery (MRS), rehospitalizations, and complication-related interventions. Recovery duration was defined as the interval between the initial surgery/treatment and the final physical/occupational therapy claim. Outcomes were summarised using medians and interquartile ranges (IQR). Among 7,112 patients, the median index treatment cost was $5163 (IQR: $994-$12,444), and the recovery duration was 88 days (IQR: 36-492). Thirty-eight percent of patients required more than 6 months to complete recovery. Post-treatment complications were associated with markedly longer and more expensive recovery. Patients who required a complication-related surgery had a recovery duration that was 4 times longer and incurred costs that were 8 times greater than those without such events. Joint contracture and MRS were strongly associated with prolonged and costly recoveries. This claims‑based analysis identified wide variation in short‑term recovery after ankle fracture. Strong associations were demonstrated between complications, including joint contracture, MRS and rehospitalizations, and extended recovery duration and higher costs. These findings may help clinicians identify patients at risk for delayed recovery and support more informed decision‑making in early post‑treatment care.

6. Effect of an Integrated Physical Activity and Nutrition Education Program Delivered by Physical Educators.

期刊: The Journal of school health 发表日期: 2026-Jun 链接: PubMed

摘要

Few school-based interventions integrate nutrition with physical activity (PA), especially within physical education classes. This study evaluated the effect of a nutrition education program designed for physical educators (PEs) that combined nutrition education with PA. In this cluster-randomized study, classes were assigned (class level) to a control (n = 11; 140 students) or an intervention group (n = 8; 143 students) over 4 months. PEs (n = 7) and students (n = 283) completed questionnaires pre- and post-intervention. Primary outcomes included students’ nutrition knowledge, attitudes, environments, behaviors, and dietary intake. Additionally, PEs’ appreciation, relevance, and use of the program and self-reported and measured compliance were evaluated. Mixed-effects models were used for analysis. Students in the intervention group showed a greater improvement in nutrition knowledge than those in the control group (adjusted mean change: +3.6 versus +1.3 points, respectively; p < 0.001). No significant changes were observed for other outcomes. Providing PEs with tailored resources enables them to effectively integrate health promotion into physical education classes. A nutrition education program for PEs has the potential to improve students’ nutrition knowledge and offers a feasible approach to incorporate nutrition education into the physical education curriculum.

7. Dynamic Monitoring of Temporal Metabolomic Perturbations in Nile Tilapia Induced by PFOA Using Homemade Extraction Electrospray Ionization Mass Spectrometry.

期刊: Environmental science & technology 发表日期: 2026-May-03 链接: PubMed

摘要

Persistent organic pollutants, represented by perfluorooctanoic acid (PFOA), have traditionally been evaluated for aquatic toxicity through static end point analyses, particularly lacking time-series analyses of dynamic metabolic pathways. This study integrated noninvasive skin mucus sampling with extractive electrospray ionization mass spectrometry (EESI-MS) to, for the first time, longitudinally and continuously track metabolic trajectories in individual Nile tilapia exposed to PFOA (0.2-20 μg/L) over 21 days. Dynamic responses of oxidative stress biomarkers and metabolomic profiles were systematically characterized through integrated analyses. Utilizing the three-dimensional extraction-ionization capability of EESI-MS, the temporal dynamics of 249 differential metabolites were captured, revealing a three-stage progression of toxicity: in the early exposure stage (days 1-3), histidine metabolism was activated to alleviate oxidative stress; in the midstage (days 7-14), glutathione and arachidonic acid metabolism were enhanced, signaling the initiation of antioxidant defense and inflammatory cascades; in the late stage (day 21), tryptophan metabolic disturbances may have triggered neurological dysfunction. The study unveils the progressive toxicity mechanism of PFOA from oxidative damage to neurotoxicity, providing a transformative monitoring paradigm for real-time risk assessment and ecological toxicity classification of per- and polyfluoroalkyl substances (PFASs) in aquatic environments.

8. Prospective Trial of Radiofrequency Catheter Ablation of High Dominant Frequencies After Pulmonary Vein Isolation in Non-Paroxysmal Atrial Fibrillation (PAD-AF Trial): A Multicenter, Randomized Clinical Trial.

期刊: Journal of cardiovascular electrophysiology 发表日期: 2026-May-03 链接: PubMed

摘要

The role of dominant frequency (DF)-guided ablation after pulmonary vein isolation (PVI) in persistent atrial fibrillation (AF) remains uncertain. We evaluated the clinical and mechanistic impact of DF mapping in a multicenter randomized study. In this multicenter, prospective study, 103 patients were enrolled. Patients with high-DF sites (≥ 7 Hz) were randomized 1:1 to PVI plus DF ablation (DF group, n = 32) or PVI alone (PVI group, n = 32). Patients without high-DF sites (< 7 Hz, n = 39) underwent PVI only (non-DF group; exploratory cohort). The primary endpoint was freedom from documented AF recurrence without antiarrhythmic drugs (AADs) at 12 months. AF-free survival off AADs was 81.3% in the DF group versus 68.9% in the PVI group (p = 0.228) at 12 months. Arrhythmia-free survival with or without AADs was 78.1% versus 65.6% (p = 0.263). The non-DF group showed the most favorable outcomes (83.3%, p = 0.065 vs PVI group). No adverse events were associated with DF mapping or ablation. Multivariate analysis identified right atrial (RA) low-voltage area extent (HR 1.031, 95% CI 1.005-1.058, p = 0.018) and LA diameter (HR 0.899, 95% CI 0.816-0.991, p = 0.032) as independent predictors of recurrence. In this multicenter randomized trial, adjunctive DF-guided ablation following PVI did not result in a statistically significant improvement in arrhythmia-free survival compared with PVI alone. However, the absence of high-DF sites was associated with favorable outcomes, and RA low-voltage burden emerged as an independent predictor of recurrence, supporting the potential mechanistic value of DF mapping and highlighting the prognostic importance of right atrial structural remodeling. UMIN000042543.

9. The prospective association between mindfulness and flourishing in mid-to-late life.

期刊: Aging & mental health 发表日期: 2026-May-03 链接: PubMed

摘要

Policymakers are increasingly interested in positive factors that enhance people’s holistic well-being, and mindfulness is one such positive psychological factor. This study examined the prospective association between mindfulness and flourishing in mid-to-late life. Three waves of data from the Midlife in the United States Study were used (1995-2014, N = 2,496, mean age = 56 years). Generalized estimating equation models were used to examine the association between mindfulness in wave II and flourishing 10 years later in wave III, adjusting for various potential confounders and prior levels of flourishing assessed in wave I. The highest vs. lowest quartile of mindfulness was positively associated with composite flourishing (ß = 0.26, 95% CI = 0.17, 0.36) and all three of its key domains, including: emotional (ß = 0.22, 95% CI = 0.11, 0.33), psychological (ß = 0.23, 95% CI = 0.13, 0.34), and social well-being (ß = 0.20, 95% CI = 0.09, 0.31). When further evaluating the subdomains nested within the three primary domains, we observed that mindfulness displayed especially strong associations with personal growth and social contribution, but little associations with purpose in life or social actualization, and potentially an inverse association with social coherence. This study suggests that cultivating mindfulness may be a meaningful avenue for promoting overall flourishing in middle-aged and older adults.

10. The association of food insecurity with psychological distress and health-related quality of life in the general adult population of Lebanon.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

The socio-economic situation in Lebanon has been dramatically deteriorating over the years affecting food insecurity (FI), psychological distress, and health-related quality of life (HRQoL). Therefore, the objectives of the study are to estimate the prevalence and severity of FI among Lebanese residents; evaluate the association between FI and psychological distress; and examine the association between FI and HRQoL. A cross-sectional study was conducted among residents of Lebanon aged 18 years or older in 2024. The final sample included 519 participants. The Food Insecurity Experience Scale, Beirut Distress Scale (BDS), and EQ-5D-5 L were used to assess FI, distress, and HRQoL levels, respectively. The questionnaire also included sociodemographic and general health-related questions. Regression analysis was applied to explore the association of FI with psychological distress and HRQoL after adjustment for relevant covariates. 14.3% of the participants exhibited moderate to severe FI. A moderate level of HRQoL was shown with a mean of 74.18 (SD = 19.0) for the EQ-VAS. Moreover, FI was significantly associated with HRQoL and psychological distress. FI (B = 5.183), age (B = 0.092), gender (B = 3.998), employment status (B = 0.558), and job loss (B = 6.021), were significant predictors of the BDS (p < 0.05). Whereas FI (B = - 8.490), age (B = - 0.461), job loss (B = - 4.659), and household income (B = 1.466) were significant predictors of EQ-VAS (p < 0.05). FI was associated with poorer mental health and lower HRQoL among Lebanese residents. This highlights the impact of the socio-economic crisis and provides data that could guide efforts to improve population health, especially for NGOs that are providing support to local communities. Lebanon has been facing severe socio-economic crises over the past years that have negatively affected food security, people’s mental health, and overall wellbeing, yet no population-based studies have been conducted to date to explore these issues. This study investigates the association of food insecurity with mental health, specifically psychological distress, and health-related quality of life. It aims to identify vulnerable groups that are most affected by the crises in order to develop targeted interventions. The study measures the prevalence of food insecurity among Lebanese residents and examines whether it is associated with higher psychological distress and lower health-related quality of life. Results revealed that about 14% of the participants were food insecure (moderate to severe FI) and it was linked to higher distress levels, and poorer health-related quality of life. Female, older individuals, unemployed, those who lost their jobs because of the crisis, those with lower educational attainment, and lower monthly income, showed worsened outcomes. The study revealed key dimensions of health that have been affected and provided data that could guide efforts to improve health of the population, especially for various NGOs that are providing support to local communities.

11. Association between child ADHD and caregivers' mental health and health-related quality of life: results from a population-based study.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

12. Factors associated with preoperative health-related quality of life in patients undergoing lumbar spine surgery: a multi-ethnic Asian cohort.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

To examine sociodemographic, clinical, and healthcare-related factors associated with preoperative health-related quality of life (HRQoL) among patients undergoing surgery for degenerative lumbar spine conditions in a multi-ethnic Asian population. This cross-sectional study used baseline data from the Spine PROM Surgery Registry, including 1194 patients scheduled for surgery within a Singapore healthcare cluster between 2017 and 2022. HRQoL was measured using the EQ-5D-3L, with utility scores crosswalked to the EQ-5D-5L index using the van Hout crosswalk. Hierarchical linear regression assessed factors associated with HRQoL across three blocks: sociodemographic, clinical, and healthcare/lifestyle. Multivariable logistic regression identified factors associated with reporting problems within each EQ-5D dimension. Mean age was 58.1 years (SD 16.1); 51.5% were female. Mean EQ-5D-5L index was 0.43 (SD 0.38). Pain/discomfort (93.6%) and usual activities problems (84.3%) were most commonly reported. Lower EQ-5D scores were independently associated with non-outpatient presentation (β = -0.37), non-Chinese ethnicity (e.g., Malay: β = -0.10), secondary education (β = -0.15), and accident/trauma history (β = -0.11). Dimension-level analyses showed secondary education was associated with higher odds of problems in mobility (OR = 2.72), self-care (OR = 1.87), usual activities (OR = 1.80), and anxiety/depression (OR = 1.97). Non-outpatient presentation was associated with markedly higher odds of self-care problems (OR = 2.98). Patients awaiting lumbar spine surgery appear to have impaired preoperative HRQoL. Although the modest explained variance limits robust risk prediction, preoperative profiles may still help inform clinical discussions and shared decision-making. Non-outpatient presentation may help identify patients who could benefit from enhanced preoperative support, although this requires prospective validation. Differences by ethnicity and education suggest opportunities for culturally tailored counselling. EQ-5D dimension profiles may indicate targets for prehabilitation and provide Singapore-based benchmark data for a lumbar spine surgery cohort for patient-centred care, service benchmarking, and health technology assessment. Low back pain is a common reason why people lose the ability to work, move, and take part in daily life. Many patients with long-lasting back problems eventually need surgery, but their quality of life before surgery can vary widely. Understanding how patients feel and function before surgery is important for planning care, setting expectations, and deciding who may need extra support. This study looked at how good or poor quality of life is in patients waiting for surgery for degenerative lumbar spine conditions, and which personal, social, and clinical factors are linked to worse quality of life. We studied over 1100 patients in Singapore using a standard health questionnaire that measures mobility, self-care, daily activities, pain, and mental wellbeing. This allowed us to examine both overall quality of life and specific problem areas. We found that patients had substantial problems before surgery, especially with pain and daily activities. Quality of life did not differ by diagnosis, but was worse in patients who entered care through emergency or inpatient routes, and in some ethnic and educational groups. These findings suggest that identifying patients with poorer preoperative quality of life may help clinicians tailor support and plan care before surgery.

13. WOMAC-based recovery after total knee arthroplasty in a multiethnic Asian cohort: a 5-year registry-based study of interval-specific predictors of improvement.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

Patient-reported outcomes (PROs) after total knee arthroplasty (TKA) are well-documented in Western populations, but long-term recovery and its determinants in multiethnic Asian populations remain poorly understood. We aimed to characterise 5-year WOMAC recovery after TKA and to identify patient, clinical, and surgical factors associated with the odds of improvement at each consecutive postoperative interval in a multiethnic Asian cohort. This registry-based cohort study used prospectively collected data from a tertiary hospital in Singapore. We included 4964 consecutive cases with osteoarthritis undergoing primary TKA between December 1, 2008, and December 31, 2023. The primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total and subscale scores, measured at baseline and at 6 months, 1, 2, and 5 years postoperatively. The mean (SD) total WOMAC score improved from 38.6 (15.1) at baseline to 7.5 (9.2) at 5 years. The greatest improvement occurred within the first 6 months (mean change, 27.6 points; P value < .001). In multivariable interval-specific analyses, older age (≥ 75 years; OR 0.55, 95% CI 0.39-0.79) and the presence of one or more comorbidities (OR 0.83, 95% CI 0.71-0.96) were independently associated with lower odds of long-term improvement. Interval-specific associations with ethnicity were also observed for pain and stiffness. In this large, multi-ethnic Asian cohort, TKA was associated with substantial and durable WOMAC improvements, primarily within the first 6 months. Interval-specific predictors of improvement were dominated by patient-level factors, notably age, comorbidity, and ethnicity, while surgical variables showed limited association. These findings support the potential value of patient-centred risk stratification and culturally responsive perioperative care in optimising long-term outcomes.

14. Assessing content validity: challenges of conducting systematic reviews of patient-reported outcome measures and recommendations to improve the application of COSMIN guidance.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

15. Health-related quality of life measures in incarcerated populations: a scoping review.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

Incarcerated populations face greater health challenges, including higher rates of communicable and mental diseases. However, traditional health measures like disease prevalence and life expectancy do not capture their physical, mental, emotional, and social well-being. This scoping review will summarize the health-related quality of life (HRQoL) outcomes in incarcerated populations using preference-based HRQoL instruments (and measures that can be used to derive utility scores), providing insights for health policies and economic evaluations. A scoping review was conducted following PRISMA-ScR guidelines. Six electronic databases and three health technology assessment agencies were searched for peer-reviewed studies reporting preference-based HRQoL or HRQoL scores that can be used to generate health state utility values in incarcerated populations. Eligibility and data extraction were performed by two independent researchers.Findings were synthesized to identify knowledge gaps. Twenty-two articles met the inclusion criteria, primarily focusing on male and white populations. Ten studies targeted disease-specific populations, with mental health disorders (n = 7) being the most prevalent. Across studies, inmates generally reported lower HRQoL scores than the general population, especially those with mental health issues. Female and Indigenous inmates had lower HRQoL scores than male and non-Indigenous inmates. The variety in HRQoL instruments used, with each assessing different domains, hinders direct comparisons between studies. Validating instruments specific to incarcerated populations may be needed for future research. Overall, incarcerated populations, especially women and Indigenous inmates, demonstrate poorer HRQoL than the general population. There is a need for more diverse, inclusive studies to address these gaps. Incarcerated populations face greater health issues that are not fully captured by traditional health measures. Health-related quality of life (HRQoL) provides a more comprehensive view of their physical, mental, emotional and social well-being. This study summarizes HRQoL research in incarcerated populations using standardized tools. The purpose of this study is to provide a scoping review of the HRQoL outcomes of incarcerated populations, summarizing existing research and identifying gaps in the literature. Our findings reveal that inmates generally have lower HRQoL scores compared to the general population, and those with mental health issues reporting the lowest scores. Additionally, female and Indigenous inmates tend to have poorer HRQoL than male and non-Indigenous inmates. The findings highlight the need for HRQoL tools specifically tailored to incarcerated populations and call for more diverse studies, particularly for underrepresented groups.

16. Real-World Treatment Patterns and Clinical Outcomes Among Chinese Patients with Stage III NSCLC: The MOOREA Study.

期刊: Targeted oncology 发表日期: 2026-May-03 链接: PubMed

摘要

Stage III non-small cell lung cancer (NSCLC) presents marked heterogeneity under evolving therapeutic paradigms. Real-world evidence on current treatment practices and outcomes remains limited. The MOOREA study aimed to evaluate real-world molecular testing, treatment patterns, and clinical outcomes of treatment-naïve Chinese patients with stage III NSCLC. MOOREA is a prospective, multicenter Chinese study enrolling patients with untreated stage III NSCLC (16 July 2019 to 28 February 2022) from 28 hospitals. Patients were consecutively enrolled. The primary endpoint was treatment pattern of cohort 1 (C1; unresectable stage III NSCLC), and the secondary endpoints included molecular testing pattern, progression-free survival (PFS), overall survival (OS) of C1, and treatment pattern of cohort 2 (C2; resectable stage III NSCLC). In total, 486 patients were analyzed (C1: 379; C2: 107). Molecular testing rates were: EGFR (20.0%), ALK (15.0%), and PD-L1 (13.0%). Of the 45.6% (173/379) of individuals in C1 who received chemoradiotherapy (CRT), 53.8% (93/173) underwent consolidation therapy, including 37.6% (35/93) who received immunotherapy (IO). In C2, lobectomy was the main surgical approach (85.8%, 91/106), whereas pneumonectomy was performed on 14.2% of patients (15/106). Adjuvant treatment was planned for 71.4% (75/105) of the patients in C2. For C1, the median follow-up was 27.5 months, with PFS and OS of 12.6 (95% CI: 11.0-14.0) and 33.3 months (95% CI: 29.6-not estimable), respectively. Subgroup analysis showed better OS and PFS for patients receiving CRT with IO consolidation versus CRT only, especially for those who underwent more than six IO consolidation cycles (24-month OS: 79.3% versus 66.4%; PFS: 49.6% versus 24.2%). MOOREA reveals the real-world management of stage III NSCLC in 20 provinces/cities in mainland China and Hong Kong SAR. Patients with unresectable tumors derived significant benefit from radiotherapy and consolidation after CRT. Substantial disparity persists between actual practice and guideline recommendations, necessitating efforts to enhance adherence to guideline-based care. NCT04023812.

17. Do non-responders of a geriatric screening questionnaire face lower one-year survival compared to responders? A retrospective cohort study.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

18. An Examination of Perceptions and Usage of Dried Blood Spot Biosampling Technology for HIV Viral Load Collection Among Youth with HIV.

期刊: AIDS and behavior 发表日期: 2026-May-03 链接: PubMed

摘要

Dried blood spot (DBS) biosampling holds promise for expanding routine viral load (VL) monitoring for youth with HIV (YWH), particularly those at highest risk for HIV medication non-adherence. This mixed methods study piloted home-based DBS collection with YWH, aged 15-24 years. We enrolled 34 YWH with suppressed VL from April 22, 2020, to December 15, 2021, a subset of a fully virtual, nationwide decentralized clinical trial (ATN 144 SMART). Participants were mailed a HemaSpot™-HF kit and asked to complete a computer-assisted self-interview (CASI) with an instructional DBS video. Surveys and semi-structured interviews provided quantitative and qualitative data to assess feasibility, appropriateness, and acceptability of home-based DBS for VL monitoring. Of 239 total screener attempts, 134 individuals were eligible and 115 provided contact information/completed the screener; 34 enrolled and returned DBS kits. Descriptive analyses showed a positive relationship between perceived suitability, feasibility, and acceptability. Perceived suitability was negatively associated with age, and feasibility differed significantly by health insurance coverage. Qualitative findings identified facilitators such as clinic/provider support, awareness of DBS innovation, insurance coverage, and streamlined mailing processes. Barriers included living environment challenges, cost concerns, and mail delivery issues. This pilot supports a self-management model and provides preliminary evidence that home-based DBS collection is feasible and acceptable among YWH. Scaling up this method through clinic and provider promotion could transform YWH HIV care by enabling remote VL monitoring. Findings also underscore the value of DBS as a practical biospecimen collection strategy for decentralized research models.

19. The mediating role of life skills in the association of the coach-athlete relationship with youth athletes' well-being.

期刊: Discover mental health 发表日期: 2026-May-03 链接: PubMed

摘要

The coach-athlete relationship is central for the development and well-being of adolescent athletes, but the mechanisms underlying this relation are underexplored. Learning life skills may explain these underlying mechanisms; therefore, understanding this line of inquiry can help optimize the coaching process and life skill development. Given this context, this study aims to analyze how the interactions between coaches and adolescent athletes are associated with well-being, as well as understand the statistical mediating role of life skills. A total of 312 Brazilian adolescent athletes participated, completing measures assessing the coach-athlete relationship, life skills and well-being. The paths (coach-athlete relationship → life skills → well-being) were tested using structural equation modeling. As a result, life skills showed a statistical indirect association accounting for 45.7% of the variance explained in the association between the coach-athlete relationship with well-being. Among the dimensions associated with the coach-athlete relationship, commitment emerged as a significant correlate of all life skills. Moreover, complementarity showed a direct association with all three well-being domains. Additionally, closeness showed a specific direct association only with psychological well-being. With regards to life skills, goal setting was positively associated with all three well-being domains, whereas emotional skills showed a negative association, suggesting that they may function as a marker of prior adversity. Taken together, the coach-athlete relationship is not a monolithic construct; its dimensions show functional specificity in their associations. From an applied standpoint, sport-based programs should prioritize building a relationship of commitment as a foundational element to support the intentional teaching of skills.

20. Factors associated with health state valuations: a secondary analysis of an EQ-5D-3L valuation study from Jordan.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

21. Physical activity levels and HINT-8 health-related quality of life in Korean adults with diabetes: analysis of KNHANES 2019-2021.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

22. Low Influenza Vaccine Awareness and Uptake Among Pregnant Women in Split-Dalmatia County, Croatia: A Cross-sectional Survey.

期刊: Maternal and child health journal 发表日期: 2026-May-03 链接: PubMed

摘要

Pregnant women face increased risks from influenza complications, underscoring the importance of vaccination. This study evaluated knowledge and attitudes about influenza vaccination and self-reported vaccination rates among pregnant women in Split-Dalmatia County, Croatia. A cross-sectional study was conducted from March to July 2020 in primary healthcare gynecological clinics in Split, Croatia. A convenience sample of pregnant women completed an anonymous 33-question survey after providing informed consent. Data were analyzed with a chi-square test, Fisher’s exact test, or Kruskal-Wallis test, as appropriate. Among 323 participants, only 10 (3.2%) received the influenza vaccine during pregnancy. Most respondents (96.3%) reported that healthcare providers did not offer them influenza vaccine. Insufficient knowledge about influenza vaccination was observed, with a median score of 38.46 (IQR = 23.08-53.85) out of 100. Higher education was significantly associated with better knowledge about influenza vaccination (P = 0.006), while age was not (P = 0.441). The primary reason cited for not getting vaccinated was a lack of information about the influenza vaccine (n = 144, 46%). Media sources such as radio, television, and the Internet were the most common sources of vaccine information (n = 89, 40%), while only a small fraction (n = 15, 6.7%) received information from their gynecologist. Low self-reported vaccination rates among pregnant women in Split-Dalmatia County were primarily due to insufficient awareness and inadequate information from healthcare professionals. Improved education and proactive vaccine promotion by healthcare providers are critical to addressing this gap.

23. The neuroplasticity-based model (NBM): an updated neurorehabilitation model that emphasizes evidence-informed strategies to induce neuroplastic changes.

期刊: Disability and rehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

Since its inception, neurorehabilitation principles guiding patient/client assessment and management have evolved alongside scientific discoveries. Historically, three models have shaped neurorehabilitation assessment and intervention: muscle-reeducation, neurotherapeutic facilitation, and contemporary task-oriented approaches, grounded in reflex, hierarchical, and systems theories of motor control and recovery. In recent decades, neuroplasticity research has challenged established principles of neurorehabilitation, supporting a shift toward an updated model. The purpose of this paper is to describe the implications of neuroplasticity research for neurorehabilitation and propose a new model that integrates emerging theories of adaptive neuroplasticity promotion in rehabilitation. This special interest paper explores the current understanding of neuroplasticity and the implications of these findings for management of neurologic movement dysfunction. Based on the current literature, we propose and describe a fourth neurorehabilitation model, the Neuroplasticity-Based Model (NBM), that may better guide clinical assessment and management. The NBM’s five therapeutic aims include optimal intervention delivery, experiences designed to focus attention, intentional experiences to induce physiological stress, health promotion strategies, and behavioral change support. These aims are tailored to individual factors to create client-centered interventions that promote adaptive neuroplasticity. The NBM offers a comprehensive framework for integrating emerging neuroplasticity discoveries into neurorehabilitation practice. Current neurorehabilitation models require updating to integrate recent neuroplasticity research into the recovery process.The Neuroplasticity-Based Model (NBM) proposes four core therapeutic aims applied according to individual factors to induce neuroplastic changes during rehabilitation.Rehabilitation professionals are encouraged to systematically design motor training that includes a “just-right challenge” to assure cognitive effort while also promoting success to motivate further efforts.During therapy, clinicians should apply interventions that prioritize one function at a time, promoting specificity and optimizing neuroplastic changes related to that function.

24. Non-Cancer Causes of Death in Patients With Metastatic Hormone-Sensitive Prostate Cancer: A Real-World Analysis.

期刊: The Prostate 发表日期: 2026-May-03 链接: PubMed

摘要

As overall survival improves in metastatic hormone-sensitive prostate cancer (mHSPC), non-cancer causes of death are increasingly relevant. We conducted a real-world multicenter study of patients diagnosed with mHSPC treated with ADT alone or in combination. Causes of death before progression to castration-resistant prostate cancer (CRPC) were classified as cancer- or non-cancer-related. Deaths were classified as non-cancer-related if they occurred in the absence of cancer progression. Among 565 patients, 35 (6.2%) died from non-cancer-related causes without disease progression, mainly infections (34%) and cardiovascular events (20%). Non-cancer mortality represents a meaningful proportion of deaths in mHSPC, supporting systematic cardiovascular risk evaluation and infection-prevention strategies.

25. An Unexpected Cause of Marathon Dyspnea: A Diagnostic Challenge in an Amateur Athlete.

期刊: The American journal of case reports 发表日期: 2026-May-03 链接: PubMed

摘要

BACKGROUND Above-average exercise capacity and a high threshold for symptoms such as dyspnea or chest pain in athletes can create false reassurance regarding the absence of clinically significant coronary artery disease (CAD). The aim of this report is to present the diagnostic reasoning and therapeutic management of an amateur endurance athlete who developed exertional dyspnea during a marathon run. CASE REPORT A 50-year-old man who was an amateur long-distance runner with a history of hypertension, hyperlipidemia reported recurrent exertional dyspnea with the onset approximately at the 20th kilometer of a marathon run, forcing a short rest but not preventing completion. Cardiopulmonary exercise testing (CPET) showed normal exercise capacity (peak oxygen uptake of 34 ml/min/kg, 104% of the predicted value). No dyspnea or chest pain occurred during maximal exertion, although ECG showed 1- to 2-mm ST-segment depression and T-wave changes in leads II, III, aVF, V5, and V6. Coronary computed tomography angiography (CCTA) showed a circumferential non-calcified plaque in the left anterior descending (LAD) artery, suggesting spontaneous coronary artery dissection. Coronary angiography confirmed severe left anterior descending artery (LAD) disease with 80% stenosis in segment 6 and a critical lesion in segment 7. Two drug-eluting stents were implanted into the LAD during a single procedure. CONCLUSIONS Firstly, supranormal exercise capacity and mildness of symptoms in endurance athletes can mask advanced CAD. Secondly, electrically positive CPET findings (1-2 mm ST-segment depression) warrant further anatomical assessment even in patients with low risk factor-weighted clinical likelihood. Finally, CCTA should be considered early in athletes with new-onset exertional symptoms, as it can reveal significant stenosis.

26. Complete genome sequence of a lytic phage, vB_KaeP_KM5, infecting multidrug-resistant Klebsiella aerogenes.

期刊: Archives of virology 发表日期: 2026-May-03 链接: PubMed

摘要

We report the complete genome sequence of the bacteriophage vB_KaeP_KM5, which infects multidrug-resistant Klebsiella aerogenes and was isolated from hospital wastewater. The phage is classified within the class Caudoviricetes, family Autotranscriptaviridae, and genus Teetrevirus.

27. DEHP disrupts lipid Metabolism via autophagy hyperactivation and mitochondrial dysfunction.

期刊: Autophagy 发表日期: 2026-May-03 链接: PubMed

摘要

Di(2-ethylhexyl) phthalate (DEHP) is a widely used industrial plasticizer, raising global concerns due to its potential endocrine-disrupting effects and environmental persistence. Human exposure to DEHP primarily occurs through the ingestion of contaminated food and water, inhalation of airborne particles, and dermal contact with products containing DEHP. Understanding the toxicological mechanisms of DEHP is essential for evaluating its health risks and developing effective strategies to mitigate its adverse effects. In this study, we conducted long-term exposure experiments to DEHP using both an animal model and in vitro system to investigate the complex interplay among DNA methylation, hyperactivation of macroautophagy/autophagy, mitochondrial dysfunction, and lipid accumulation induced by DEHP. The results revealed that DEHP exposure induced the degradation of DNMT1 (DNA methyltransferase 1) by enhancing its interaction with the autophagy-related protein SQSTM1 (sequestosome 1). DNMT1 degradation resulted in decreased methylation of the promoter regions of genes associated with autophagosome formation, subsequently increasing their expression. The resulting demethylation excessively activated autophagy, contributing to mitochondrial dysfunction and lipid accumulation in the liver. This study uncovered a previously unrecognized interplay among hyperactivation of autophagy, mitochondrial dysfunction, and lipid accumulation in the context of DEHP exposure. These findings enhanced our understanding of DEHP’s toxicity and underscored concerns about the long-term health effects of environmental pollutants, particularly regarding metabolic diseases.

28. Transforming Prenatal Care in a Highly Inbred Population: Impact of a Multidisciplinary Board.

期刊: Prenatal diagnosis 发表日期: 2026-May-03 链接: PubMed

摘要

This study aims to evaluate the outcomes of a new PND initiative designed to optimize healthcare delivery in a highly consanguineous population. A descriptive study was conducted at a major tertiary referral center for genetic diseases in Saudi Arabia with a large scope objective to improve the existing prenatal diagnosis (PND) process. Consequently, a new prenatal workflow featuring a structured checklist, a dedicated prenatal board, and enhanced genetic counseling has been implemented since September 2023. The study included all prenatal cases with a documented autosomal recessive (AR) disease. The program processed 1128 cases, with 952 cleared by the prenatal checklist. In total, the board has discussed 160 variants of unknown significance (VUS), of which 122 (76%) were upgraded to likely pathogenic/pathogenic. Remarkably, the prenatal checklist enhanced patient safety and reduced serious harm incidents, while the prenatal board facilitated precision medicine by leveraging collective expertise in variant interpretation. This initiative significantly improved the healthcare, safety, and accessibility of PND services. The prenatal board and checklist streamlined decision-making, minimized errors, and enhanced patient outcomes. The model provides a cost-effective approach to preventing genetic diseases in highly consanguineous populations and serves as a replicable framework for similar settings worldwide.

29. The relationship between adverse childhood experiences and periodontitis in young adults.

期刊: Journal of periodontology 发表日期: 2026-May-03 链接: PubMed

摘要

Periodontitis, a chronic inflammatory disease, is increasingly prevalent among young people and impairs their quality of life. Adverse childhood experiences (ACE), depressive symptoms, and suboptimal health status (SHS) are linked to health risks and chronic diseases, but their interrelationships with periodontitis in Chinese young adults remain unclear. This study aimed to explore associations among these factors. From December 2024 to May 2025, 2,888 participants (aged 18-35) from Tongji Hospital completed surveys on demographics, ACE, depressive symptoms, and SHS. Periodontitis was diagnosed according to the 2018 criteria. Simple, parallel, and chain mediation models were used, controlling for age, sex, marital status, and smoking. Periodontitis prevalence was 25.00% and higher in married individuals (P < 0.001) and smokers (P = 0.004). ACE correlated positively with depressive symptoms (r = 0.28, P < 0.001), SHS (r = 0.19, P < 0.001), and periodontitis (r = 0.16, P < 0.001). Mediation analyses showed: Simple model: Depressive symptoms and SHS partially mediated the effect of ACE on periodontitis (indirect effect = 0.011 for both). Parallel model: Only SHS significantly mediated the effect (indirect effect = 0.011). Chain model: ACE was related to periodontitis via “depressive symptoms → SHS” (indirect effect = 0.010), with significant direct and indirect effects. ACE associated with higher periodontitis risk in young people. This association included both a direct link between ACE and periodontitis, and an indirect link through the chain pathway of “depressive symptoms → SHS”; among these pathways, SHS was a key mediator. The study was registered in the Chinese Clinical Trial Registry (ChiCTR) with the registration number ChiCTR2500103464. Childhood trauma can exert long‐term impacts on health, including oral health. This study involving 2,888 Chinese young adults aged 18‐35 found that 25% of the participants had periodontitis. Those who experienced childhood abuse, neglect, or family issues showed a higher association with the disease. The research revealed two pathways linking early trauma to periodontitis: a direct association and an indirect chain of “depressive symptoms → suboptimal health status (e.g., persistent fatigue).” While depressive symptoms played a role, suboptimal health status was the critical mediator. Higher periodontitis rates in married individuals and smokers may relate to stress or lifestyle factors. The findings suggested that early identification of childhood trauma, combined with interventions targeting mental health or overall well‐being (e.g., counseling, health management), could be more effective than oral care alone in prevention. This underscored the association between early‐life experiences and long‐term health and the need for integrated interventions.

30. Advancing air pollution forecasting: a review of physical, statistical, and machine learning methods.

期刊: Environmental science and pollution research international 发表日期: 2026-May-03 链接: PubMed

摘要

Air pollution is one of the important environmental and public health hazards that requires a combination of assessments, monitoring, and mitigation approaches. The current review is an attempt to review the tools for monitoring and modeling air pollution data focusing on predictive forecasting. The review involves different modeling techniques, including deterministic models, statistical methods, and machine learning and deep learning techniques employed to process pollutant concentration, considering data quality, uncertainty assessment, model interpretability, and temporal and spatial scales. An emphasis is laid on hybrid and ensemble models integrating physics-based and data-driven approaches to enhance the prediction accuracy and robustness. Finally, the review explores emerging directions, such as physics-informed machine learning and edge-computing models, and identifies opportunities for open data platforms and collaborative research to promote fair and meaningful air quality management in a global context.

31. Molecular mechanisms and clinical impacts of sex differences in urologic cancers.

期刊: Discover oncology 发表日期: 2026-May-03 链接: PubMed

摘要

Urological cancers exhibit significant sex differences in incidence, treatment response, and prognosis, with males generally showing higher morbidity and mortality. This review systematically summarizes the underlying molecular and clinical mechanisms of these disparities, focusing on sex hormones, chromosome biology, tumor immune microenvironment, and microbiota. Sex hormones modulate key tumor processes including proliferation, apoptosis, non-apoptotic cell death, and DNA repair. Genetic factors such as X chromosome inactivation escape genes and Y chromosome loss also contribute to sex-biased cancer susceptibility. Furthermore, sex-specific differences in the urinary system and gut microbiota influence local immunity and inflammation, thereby affecting tumor progression and therapeutic response. Lifestyle and environmental factors, including smoking, alcohol consumption, and occupational exposures, further exacerbate these disparities. Clinically, sex differences impact the efficacy of immunotherapy and targeted therapies, underscoring the need for sex-informed treatment strategies. Integrating sex as a biological variable in research, clinical practice, and public health policies is essential for advancing precision oncology in urologic cancers.

32. Qualitative study of patient-reported outcome data collection among clinicians in dermatology at a single academic center.

期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

Patient-reported outcomes (PROs) help dermatologists better understand patient perspectives to facilitate shared medical decision-making. Despite merit-based incentive payment system (MIPS) measure to collect quality of life assessments at least once every 12 months for patients with chronic skin diseases, routine PRO collection remains uncommon in clinical practice. This semi-structured interview study aimed to elicit key preferences, facilitators, and barriers for routine PRO collection in dermatology practices. Clinicians were recruited from Emory Dermatology, which has implemented routine PRO collection. Verbatim transcripts were coded and analyzed deductively using the Theoretical Domains Framework to generate salient themes. We interviewed nine dermatologists and one advanced practice provider (APP). Professional roles of all interviewed clinicians aligned with PRO collection. Memory, attention, and decision-making requirements for PRO collection by clinicians were minimized via institutional automation in the electronic health record (EHR). Skills in navigating EHR were needed to retrieve PRO data. Environmental factors affecting PRO collection included patient portal access, IT support for EHR integration, institutional interest in PROs, limited clinician oversight on PRO collection by other staff members, and high patient volume in dermatology clinics. Social support between staff could allow workflow division and maximized opportunities for PRO collection, while clinician perceived patient survey fatigue and skepticism on PRO utility affected PRO collection. This study was limited to clinician perspectives in a single clinic. Automating PRO collection and utilization in EHR, demonstrating PRO value, establishing institutional support, and streamlining workflow are needed to broadly implement routine PRO data collection. Patient reported outcomes (PROs) data offers valuable insights from the patient perspective to dermatology clinicians about their skin conditions, facilitating shared medical decision-making. However, most dermatology clinics do not collect PROs. This study explores key preferences, facilitators, and barriers to routine PRO collection among dermatology clinicians within an academic institution that has implemented PRO collection. Through qualitative interviews, the most salient themes identified by our participants include clinician perceived patient value proposition, clinician value proposition, stakeholder engagement and the importance of automated data collection through the electronic health record to minimize disruptions in clinical workflow. Automated, pre-clinical visit PRO collection presents an opportunity to enhance clinical decision making but successful implementation requires recognition of PRO value, institutional support, clear role delineation, clinician, staff and patient education and improved EHR visualization of PRO results.

33. Adsorptive removal of methylene blue using water hyacinth roots: batch and column adsorption, kinetics, isotherm and ANN-GA modeling, scale-up, phytotoxicity, and disposal pathways.

期刊: International journal of phytoremediation 发表日期: 2026-May-03 链接: PubMed

摘要

Methylene Blue (MB), a widely used cationic dye, is of particular concern due to its persistence and adverse effects on ecosystems and human health. This study used batch and fixed-bed column adsorption studies to evaluate dried water hyacinth roots as an environmentally benign, affordable, and sustainable adsorbent for MB removal. The effects of operating parameters on MB adsorption were systematically investigated in batch experiments. Under optimized conditions (pH 6, 0.2 g dose, 90 min contact time), a maximum extraction efficiency of 96.5% was achieved. The pseudo-second-order model best describes the adsorption process. At the same time, isotherm analysis confirmed multilayer adsorption with a maximum capacity of 154.54 mgg-1 as predicted by the Freundlich model. Column experiments were conducted to evaluate continuous adsorption performance. Kinetic models, including Thomas, Yoon-Nelson, and Bohart-Adams, were utilized, with the Thomas model (R2 = 0.96) showing the strongest agreement with experimental data. A Genetic Algorithm (GA) was employed to accurately predict adsorption performance. Phytotoxicity tests of the treated effluent confirmed reduced toxicity, underscoring the environmental safety of the process. Overall, the findings establish water hyacinth root as a promising green adsorbent for the remediation of industrial dyes, with clear potential for scale-up.

34. Is the community participation and environment of children with Down syndrome different from their typically developing peers? A cross-sectional study.

期刊: Developmental neurorehabilitation 发表日期: 2026-May-03 链接: PubMed

摘要

The aim of this study was to examine the community participation levels (frequency and involvement) of children with Down syndrome (DS) and the restrictive and supportive factors affecting their participation levels and compare them with typically developing (TD) children. This cross-sectional study included parents of 70 children (35 with DS; 35 TD children) aged 8-17 years. Parents of all children completed the community module of the Participation and Environment Measure for Children and Youth, which is used to assess participation and environmental factors in the community. Children with DS participated less frequently (organizations, groups, clubs, or leadership activities and out-of-school classes and lessons) and less involved (getting together with children, organizations, groups, clubs, or leadership activities and out-of-school classes and lessons) in community activities compared to TD children, and parents of children with DS were less satisfied with their children’s participation in community activities. Children with DS faced more barriers (the physical layout, the sensory quality and weather conditions) and had insufficient resources (information and supplies) compared to their TD peers in the community. After adjusting for the child’s age, parental education level and average income, the group (DS vs. TD) had an independent effect on frequency, involvement and desire for change. Children with DS are negatively affected in terms of community participation (both) compared to TD children. Beyond sociodemographic factors, being a child with DS may reduce community participation (both). The community environmental factors were influential for the community participation of children with DS. Community participation of children with DS can be increased through environmental regulations.

35. Use of gaming as an occupation in adults with upper limb impairment: a scoping review.

期刊: Disability and rehabilitation. Assistive technology 发表日期: 2026-May-03 链接: PubMed

摘要

Gaming is a meaningful occupation for 3.3 billion people worldwide and is also used for upper limb rehabilitation. Yet, little is known regarding the use of gaming as a meaningful occupation for people with upper limb impairment. This scoping review thus explored the use of gaming through an occupational lens. This scoping review was conducted using the Arksey and O’Malley framework and Joanna Briggs Institute scoping review methodology and protocol template. Medline, CINAHL, IEEE Xplore and Embase were searched for studies that included gaming as an intervention for people with upper limb impairment. Studies exploring occupation, occupational engagement, activity or participation were included. Of the 282 studies included, only 10 explored occupational engagement. Gaming was used predominantly for stroke populations (n = 237) and conducted in a hospital setting (n = 150). Across the studies, 157 systems were used, ranging from dedicated rehabilitation robots to commercial gaming systems, and 85 different activity and participation outcome measures were reported. Qualitative studies reported themes of peer socialisation and perceived upper limb improvement that fostered gaming use. This review identified limited representation of gaming being utilised as a meaningful occupation for people with upper limb impairment. Given the importance of participating in meaningful occupations for people with upper limb disability, further research exploring the potential of gaming to promote occupational engagement is warranted.Implications for rehabilitationGaming could offer a meaningful occupation for people with upper limb impairment to enhance social connection and well-being in rehabilitation.Rehabilitation professionals should explore the role of gaming beyond therapeutic intervention, using outcome measures to assess occupational engagement.Research is needed to explore the long-term adoption and impact of gaming on participation.

36. Implementation of a patient-centered interprofessional education course for undergraduates from five health and medical professions.

期刊: Journal of interprofessional care 发表日期: 2026-May-03 链接: PubMed

摘要

Interprofessional collaboration (IPC) optimizes patient care by combining diverse expertise. Although interprofessional education (IPE) supports IPC, underreporting of key IPE components may limit its implementation in higher education. The purpose of this paper was to describe the experience of implementing an IPE course and explore the perceptions of the participating students and faculty tutors. The course was based on problem-based learning (PBL) using patient-centered learning (PCL). Peer feedback was crucial to the learning process. A qualitative-ethnographic study was conducted involving 88 students from five professions within the Faculty of Medical and Health Sciences who enrolled in the course. Data were collected using focus groups and semi-structured individual interviews (45 students and 17 tutors), as well as direct observations (36 students and eight tutors). Data analysis was conducted manually by the research team without the use of qualitative data analysis software. Students and tutors found the new course innovative and effective in preparing healthcare students for future collaboration. The strong focus on feedback distinguished it from traditional IPE courses. Due to its successful implementation, the course has become mandatory for all students.

37. Wheelchair Skills test - questionnaire for manual wheelchair users: Italian translation and preliminary validation.

期刊: Disability and rehabilitation. Assistive technology 发表日期: 2026-May-03 链接: PubMed

摘要

To translate and culturally adapt the Wheelchair Skills Test-Questionnaire (WST-Q) into Italian, and to assess its reliability, measurement error and validity in manual wheelchair users. The WST-Q was translated and culturally adapted using forward-backward translation, expert review, and cognitive debriefing with wheelchair users and rehabilitation professionals. Internal consistency (Cronbach’s α), test-retest reliability (Intraclass Correlation Coefficient, [ICC]), measurement error (Standard Error of Measurement [SEM] and the Smallest Real Difference [SRD]) were calculated. Validity was examined through WST-Q scores correlations (concurrent validity) and known-groups comparisons (years of use, training) (construct validity). A General Linear Model (GLM) was used to explore the effects of clinical and demographic factors, accounting for interaction terms. Seventy-four manual wheelchair users, with a mean age of 44.0 years (SD: 15.7), participated in the study. Cronbach’s α was 0.96-0.97 across WST-Q scores. ICCs indicated excellent test-retest reliability (0.88-0.92). SEM ranged from 4.9 to 6.9, and SRD from 13.6 to 19.3. Strong correlation among WST-Q scores was observed (p = 0.81-0.90, p < 0.001). Known-groups validity showed higher scores in participants with >2 years of wheelchair use and in those with training. GLM analysis identified significant effects of baseline pathology, wheelchair type, gender, and training, with several interaction effects, explaining 77-89% of score variance. The Italian WST-Q demonstrated excellent reliability, acceptable measurement error, and good validity. It is suitable for assessing self-reported manual wheelchair skills in Italian rehabilitation settings, supporting standardised and evidence-based practice. The Italian Wheelchair Skills Test-Questionnaire (WST-Q) demonstrated excellent internal consistency, test-retest reliability, and construct validity, supporting its use as a standardised self-report measure for manual wheelchair skills assessment in Italy.The established measurement error indices (Standard Error of Measurement and Smallest Real Difference) enable clinicians and researchers to distinguish true changes in wheelchair skills from random variation, improving the accuracy of outcome evaluation.The WST-Q can help identify differences in skill performance linked to training, wheelchair type, and health condition, informing individualised rehabilitation planning and targeted skill development interventions.

38. Evaluating Dermal Bioactivity of Metal Additive Manufacturing Powders Using Human In Vitro and Ex Vivo Skin Models.

期刊: Chemical research in toxicology 发表日期: 2026-May-03 链接: PubMed

摘要

Metal additive manufacturing (AM) relies on alloy feedstock powders that may come into contact with the workers’ skin during handling, yet skin-relevant data on metal release and biological reactivity remain limited. Here, we assessed the cutaneous bioactivity of the fine particle fraction of four gas-atomized Fe-based AM powders (316L stainless steel, Fe-powder A, and tooling steels B and C). Powders were sieved to <10 μm and characterized by scanning electron microscopy and X-ray photoelectron spectroscopy before and after incubation in artificial sweat (ASW). Metal biodissolution was quantified in ASW and keratinocyte culture medium using atomic absorption spectrophotometry. Cellular responses were evaluated in HaCaT keratinocytes using Cell Painting-based phenomics and multiplex cytokine/chemokine profiling and in an ex vivo full-thickness human skin explant model, including superficial barrier disruption, IL-8/CXCL8 quantification, and histological assessment. ASW exposure induced marked shifts in the outermost surface composition across powders, indicating sweat-driven surface transformation. Biodissolution was low and medium-dependent, with Fe dominating the release in ASW, and with an overall metal release remaining limited in cell culture medium. In HaCaT cells, MCP-1/CCL2, IL-6, and IL-8/CXCL8 were quantifiable but showed no significant changes following powder exposure. Cell Painting revealed subtle, shared phenotypic signatures, primarily involving mitochondrial-associated features, without evidence of broad cellular stress. In the ex vivo skin model, AM powders did not increase IL-8/CXCL8 secretion, the particles remained localized to the skin surface without detectable penetration, and coexposure with Staphylococcus epidermidis did not enhance bacterial colonization or induce inflammation. To the best of our knowledge, this is the first study that applies a human skin explant model to evaluate dermal responses to metal AM powders. Overall, the tested AM powders showed low short-term cutaneous reactivity under skin-relevant conditions, providing human-relevant evidence to inform occupational risk assessment in AM environments.

39. Evaluating implementation of nurse-led community-based ultrasound screening for developmental dysplasia of the hip in Japan: A mixed-methods RE-AIM study.

期刊: International journal of nursing studies 发表日期: 2026-May-02 链接: PubMed

摘要

Developmental dysplasia of the hip remains a preventable yet underdiagnosed condition. Conventional screening strategies that rely on physical examination demonstrate limited sensitivity and fail to achieve comprehensive population coverage. Although universal ultrasound screening has shown promise, evidence supporting scalable, sustainable, and nurse-led community-based implementation models within real-world public health systems remains limited. To evaluate a nurse-led community-based ultrasound hip screening program integrated into routine maternal and child health services in Japan using the Reach, Effectiveness, Adoption, Implementation, Maintenance framework. A prospective cohort study with a mixed-methods design. Three rural Japanese municipalities (February 2024 to August 2025). Public health nurses, midwives, infants, and their caregivers who underwent routine newborn home visits or child-rearing consultations in the participating municipalities. The existing maternal and child health services evaluated across the following dimensions: Reach (coverage rate); Effectiveness (the proportion and mean age of infants referred early to medical institutions, and caregiver-reported outcomes following referral); Adoption (nurse adoption rate); Implementation (the proportion of ultrasound images meeting Graf’s criteria, examination time, operational challenges, and cost); and Maintenance (continuation and policy integration). Ultrasound images were uploaded to a secure encrypted cloud server and interpreted remotely by Graf-certified pediatric orthopedic surgeons, with structured feedback provided to nurses throughout the implementation process. A total of 818 examinations were performed in 349 infants. The estimated coverage rate was 95.6%, indicating a near-universal range. Standard-plane images meeting Graf’s criteria were obtained in 85.8% of examinations. Non-Type I hips accounted for 8.7% of cases, and 7.0% of infants were referred for further evaluation. Of these referred infants, 97.6% visited medical institutions, 54.8% required continued follow-up, and 4.8% required treatment. Adoption was high, with 95.5% of trained nurses conducting screenings. Implementation challenges included infant positioning, data-upload errors, and limited digital integration; however, interprofessional feedback from orthopedic surgeons improved technical performance. Ultrasound visualization enhanced caregiver understanding and facilitated timely adherence to referral recommendations. All municipalities continued screening, demonstrating strong maintenance. Nurse-led ultrasound hip screening can be feasibly integrated into routine maternal and child healthcare systems. This model enables early identification of suspected developmental dysplasia of the hip without clinical signs, and offers an equitable approach in resource-limited settings from a precision public health nursing perspective. University Hospital Medical Information Network Clinical Trial Registry; UMIN000051929 (https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_his_list.cgi?recptno=R000059248). Registration date: September 16, 2023. Start of recruitment: November 01, 2023. Nurse-led community ultrasound hip screening achieved 95.6% coverage, and 8.7% of the screened infants had a suspected dislocation or hip dysplasia.

40. An independent validation of a clinical prediction rule for the diagnosis of cervical radiculopathy with radicular pain.

期刊: Brazilian journal of physical therapy 发表日期: 2026-May-02 链接: PubMed

摘要

A clinical prediction rule (CPR) for cervical radiculopathy (CR), published in 2003, is widely used in practice and recommended in clinical practice guidelines. To date, this CPR has not been independently validated. To perform an independent broad validation of the 2003 CPR using magnetic resonance imaging (MRI) as reference standard, and to investigate whether an alternative test cluster has stronger diagnostic utility for identifying CR with radicular pain METHODS: This prospective diagnostic accuracy study was conducted following the updated STARD 2015 guidelines. Eighty-five individuals (27 with CR) were included from 109 consecutive patients. The diagnosis of CR was based on cervical spine MRI findings consistent with the patient’s clinical features, symptoms, and neurological examination, interpreted by a neurosurgeon. Twelve clinical tests were performed by the same examiner blinded to diagnosis. Validation of the 2003 CPR (cervical distraction, Spurling’s test, upper limb neurodynamic test (ULNT) 1, and cervical rotation <60°) produced diagnostic values comparable to the original study. Our independent cluster based on backwards stepwise regression identified three variables: (1) modified (passive) shoulder abduction test, (2) Spurling’s arm pain test, and (3) ≥2 of 4 ULNTs positive. With this new cluster, having all three tests positive provided an infinite LR+ and a 100 % post-test probability, identifying 37.0 % of CR with radicular pain cases compared to 17.9 % in the original 2003 cluster (4/4 positive tests). This study findings corroborate the original 2003 CPR and identified a new cluster that had stronger diagnostic utility for CR with radicular pain.

41. Knockdown of histone deacetylase 9 ameliorates immunoglobulin a nephropathy by modulating immune response.

期刊: International immunopharmacology 发表日期: 2026-May-02 链接: PubMed

摘要

Immunoglobulin A (IgA) nephropathy (IgAN) is a common clinical autoimmune disease, and the regulatory mechanism of Histone deacetylase 9 (HDAC9) in IgAN remains unclear. This study aims to elucidate the therapeutic value and potential mechanisms of HDAC9 in IgA nephropathy, offering potential new targets for clinical intervention and further research. An adeno-associated virus 9 (AAV9)-shHDAC9 vector was constructed and investigated the protective effect of HDAC9 knockdown in IgAN mouse. Transcriptome sequencing of renal tissues from IgAN mice was conducted, and immune infiltration analysis was quantified using transcriptomic data analyzed through the CIBERSORT deconvolution algorithm. Flow cytometry was employed to assess the expression of Th17 cell, B cell, and macrophage markers in the kidney tissues of IgAN mice. In vivo animal experiments indicate that HDAC9 knockdown ameliorates renal injury and suppresses the immune system to reduce inflammation in IgAN mice. Transcriptome sequencing results suggest that HDAC9 knockdown may exert therapeutic effects on IgAN by regulating immune-inflammatory responses. Through immune infiltration analysis and single-cell data, we found that HDAC9 may modulate immune cells, particularly T cells, B cells, and macrophages. Flow cytometry further confirmed that HDAC9 knockdown effectively inhibits Th17 cell and B cell activation, as well as macrophage polarization towards the M2 phenotype in IgAN mice. The graphical abstract of this study is shown in Fig. 1. HDAC9 knockdown modulates immune responses and alleviates pathological damage in IgAN mice. HDAC9 may serve as a potential therapeutic target for IgAN.

42. Nursing faculty perceptions of soft skills teaching in undergraduate nursing education: a qualitative study.

期刊: BMC medical education 发表日期: 2026-May-02 链接: PubMed

摘要

Soft skills correspond to intrapersonal and interpersonal abilities related to how individuals interact, make decisions, and manage their activities. In the context of undergraduate nursing education, their development is fundamental to the preparation of professionals capable of acting in an ethical, critical, and relational manner, making it relevant to understand how these competencies are incorporated into the teaching and learning process. In this context, the objective of this study is to understand how faculty members in undergraduate nursing programs incorporate soft skills into their pedagogical approaches and practices, identifying the competencies considered essential and the challenges to their implementation. A qualitative study was conducted with 26 nursing faculty members from four federal public universities in southern Brazil. Data were collected between June and September 2025 through semi-structured interviews, following the criteria of the Consolidated Criteria for Reporting Qualitative Research checklist. The interviews were processed using IRaMuTeQ software and analyzed in light of Discursive Textual Analysis. Three analytical categories emerged: faculty understanding of soft skills in nursing education; pedagogical approaches and strategies for the development of these competencies; and perceived difficulties in their promotion within teaching. The faculty members recognize the relevance of soft skills and report the use of active methodologies and reflective strategies for their development. However, most had not received specific training, and the teaching of these competencies occurs predominantly in an implicit manner. The findings demonstrate that, although soft skills are widely valued in nursing education, their promotion still lacks pedagogical systematization and institutional support. Challenges such as the subjectivity of these competencies, the prioritization of technical skills by students, and distractions associated with the use of technologies limit their intentional development. These results contribute to the international literature in nursing education by highlighting the need for structured institutional strategies for faculty development and for the explicit integration of soft skills into nursing curricula.

43. Family matters: home characteristics related to dietary intake of fruit, vegetables and sugar-sweetened beverages in a national cross-sectional sample of school-aged children in the U.S.

期刊: BMC nutrition 发表日期: 2026-May-02 链接: PubMed

摘要

Home environments shape children’s dietary habits, but which factors are most influential is unclear. The study purpose was to identify factors in the home environment associated with child intake of fruit and vegetables (FV) and sugar-sweetened beverages (SSBs) using a national dataset collected in 2013-2015 in the U.S. Data from 5,138 school-aged children (4-15 years old) from 130 U.S. communities were collected in 2013-2015. Parents and/or children completed a dietary screener and additional survey questions to assess household socioeconomic status (SES), grocery shopping sources, home food availability, social support for healthy eating, eating out frequency, and other home eating and related behaviors. Other child characteristics included breastfeeding history, intake of school foods, and participation in other nutrition programs. Community variables included predominant race/ethnicity and SES. Classification and regression trees (CART) identified key predictors of intake. The FV and SSB CARTS had 14 and 12 terminal groups, respectively. Children with the highest FV intake (0.54 SD from mean cups/day; 13% of sample) had fruit more often available at home, dark green vegetables more often available at home, ate dinner with family more often, had SSBs less often available at home, and were breastfed longer. Conversely, children in the two groups with the lowest FV intake either had fruit less often available at home, and family never complimented their eating (-0.86; 2%), or they had family that rarely or sometimes complimented their eating, and perceived school lunches as unhealthy (-0.87; 1%). For SSB intake, the lowest consumers (-0.63 SD from mean tsp/day sugar; 17%) never or rarely had SSBs available at home, and lived in higher SES communities. Children in the two groups with the highest SSB intakes had SSBs available at home more often, and lived in a SNAP-participating household and either ate out less often, used a phone/computer for social networking, and had SSBs available at home very often (1.3; 1%), or they ate out more often, and were breastfed for a shorter duration (1.1; 5%). Home availability of FV and SSBs were the most salient predictors of intake of both FV and SSBs, while other predictors differed between FV and SSB intake. Study findings highlight several actionable home-environment strategies to test in future studies to improve school-aged children’s diets.

44. Measuring and increasing the brain health span across adulthood: a public health imperative.

期刊: Scientific reports 发表日期: 2026-May-02 链接: PubMed

摘要

Extending brain health span - maintaining or improving cognitive, social, and emotional well-being - is critical to aligning health span with lifespan. This study examines 3-year outcomes from 3,966 adults (ages 19-94) in the BrainHealth Project, an online initiative integrating the BrainHealth Index (BHI) with cognitive training, lifestyle modules, and coaching. The BHI, assessed biannually, provides a multidimensional measure across factors of Clarity (cognitive function), Connectedness (social and purpose-driven engagement), and Emotional Balance (mental well-being). Results demonstrate sustained improvements in overall BHI and component factors, independent of baseline scores. Higher engagement with training tools - strategy-based learning, coaching, and brain-healthy habits - was associated with the greatest gains, underscoring the role of self-agency in brain health optimization. Improvements were observed across demographic groups, suggesting benefits regardless of age, gender, or education level. Findings support the potential for scalable, technology-driven interventions to help reduce years of cognitive decline while maximizing brain performance across the lifespan. Future efforts should focus on improving demographic diversity and retention as well as integrating precision brain health into public health initiatives.Trial registration: ClinicalTrials.gov, NCT04869111 (registered April 27, 2021).

45. Personalized tacrolimus therapy in allogeneic hematopoietic stem cell transplantation: from pharmacokinetic variability to novel control strategies.

期刊: Journal of pharmaceutical health care and sciences 发表日期: 2026-May-02 链接: PubMed

摘要

Allogeneic hematopoietic stem cell transplantation is an established curative therapy for many hematological diseases, but graft-versus-host disease remains a major cause of morbidity and mortality. Tacrolimus, a calcineurin inhibitor, is widely used for prophylaxis because it suppresses T-cell activation. However, its clinical use is complicated by a narrow therapeutic window and marked pharmacokinetic variability. Therapeutic drug monitoring based on trough whole-blood concentrations is routinely used to guide dosing, but this approach has limitations, particularly in transplantation recipients who experience rapid physiological and hematological changes. This review summarizes recent insights into determinants of tacrolimus pharmacology in hematopoietic stem cell transplantation and discusses emerging perspectives for individualized dosing. Tacrolimus exerts its immunosuppressive effects by forming a complex with FK506-binding proteins that inhibits calcineurin and suppresses activation of nuclear factor of activated T cells. Beyond this canonical mechanism, interactions with FK506-binding proteins influence the distribution of tacrolimus within blood cells. Because tacrolimus strongly divides into erythrocytes and leukocytes, whole-blood concentrations reflect systemic exposure and drug binding within circulating blood components. In recipients of hematopoietic stem cell transplantation, marked fluctuations in blood cell counts during conditioning therapy and hematopoietic recovery can alter this distribution, potentially causing changes in concentrations without corresponding changes in pharmacologically active exposure. Genetic variation in drug-metabolizing enzymes further contributes to variability in tacrolimus pharmacokinetics. In particular, polymorphisms in the gene encoding cytochrome P450 3A5 influence tacrolimus metabolism and may affect early dose requirements during the post-transplant period. Additionally, temporal fluctuations in tacrolimus exposure within individual patients are increasingly recognized as clinically relevant. Measures that capture the proportion of time during which concentrations remain within the therapeutic range provide a useful indicator of exposure stability. Tacrolimus therapy after hematopoietic stem cell transplantation is influenced by molecular pharmacology, blood cell-dependent distribution, genetic determinants of metabolism, and temporal variability in drug exposure. Integrating these factors may improve understanding of therapeutic drug monitoring and promote more individualized strategies to maintain stable immunosuppression and improve transplant outcomes.

46. Fibroblast-mediated KRAS activation in double-negative prostate cancer.

期刊: Cell death & disease 发表日期: 2026-May-02 链接: PubMed

摘要

When androgen receptor (AR) signaling is suppressed, prostate cancer progression is inhibited; however, many patients eventually relapse, developing castration-resistant prostate cancer (CRPC). Recently, the incidence of double-negative CRPC (DNPC)-which lacks AR and neuroendocrine activity-has increased, yet effective treatments remain unavailable. Our research demonstrated that KRAS has minimal influence during the AR-dependent stages of prostate cancer but significantly activates cancer cells when AR signaling is suppressed. Further investigation revealed that AR inhibition modifies fibroblast growth factor receptor expression in prostate cancer cells. Additionally, CCL2, secreted by AR-inhibited prostate cancer cells, induces FGF8b secretion from stromal cells within the tumor microenvironment, which in turn enhances KRAS activation. A pan-KRAS inhibitor effectively suppressed AR-independent prostate cancer cells by disrupting KRAS-mediated cell survival signaling. This inhibition led to the significant induction of programmed cell death, characterized by the downregulation of the anti-apoptotic protein BCL-xL and the promotion of apoptosis as evidenced by increased cleaved caspase-3 in vivo. These findings highlight KRAS activation, driven by the CRPC microenvironment, as a critical factor in DNPC progression and identify the induction of KRAS-targeted cell death as a promising therapeutic strategy for DNPC.

47. Supporting breast and cervical cancer screening follow-up: qualitative health plan interviews.

期刊: BMC health services research 发表日期: 2026-May-02 链接: PubMed

摘要

Breast and cervical cancer represent a significant disease burden. Health care quality measures captured through electronic clinical data systems could be used to assess follow-up of abnormal breast and cervical cancer screening results. The National Committee for Quality Assurance (NCQA) wanted to explore the feasibility of using health plan electronic clinical data systems to develop quality measures for follow-up of abnormal breast and cervical cancer screening test results. NCQA interviewed quality improvement leaders from ten health plans, recruited through a purposive sample representing varying sizes, geographic regions, and commercial, Medicare, and Medicaid product lines. Health plan leaders identified several barriers, including a lack of standardized data integration as well as opportunities such as supporting provider and health system data aggregation and other support. Findings indicate that improved data governance, particularly around data standardization and information technology infrastructure integration, would increase the feasibility of monitoring follow-up after abnormal breast and cervical cancer screening results.

48. A qualitative study on family health needs of community-dwelling disabled older adults based on existence-relatedness-growth theory.

期刊: BMC geriatrics 发表日期: 2026-May-02 链接: PubMed

摘要

As the primary living environment for disabled older adults, families play a crucial role in disease prevention and maintaining their health. However, research has found that both disabled older adults and their family members experience numerous physiological, psychological, and social adaptation problems when adjusting to the changes brought by disability, severely impacting the overall health status of the family. Therefore, guided by the ERG (Existence-Relatedness-Growth) theory, this study aims to understand the family health needs of families with disabled older adults in the community, providing a basis for improving the health level of these families and developing targeted intervention programs. From December 2024 to February 2025, this study employed purposive and snowball sampling to select 12 pairs of disabled older adults and their primary caregivers from communities under the jurisdiction of Zhengzhou City, Henan Province for semi-structured interviews. Thematic analysis was applied to organize and analyze the interview data. Deductive analysis indicated that the famliy health needs of families with disabled older adults in the community can be summarized into the following three themes: existence needs (daily living needs, economic support needs, environmental modification needs), relatedness needs (family communication needs, social resource connection needs, social participation needs), and growth needs (autonomy and dignity maintenance needs, family development needs, demand for technology-enabled solutions). The results show that the family health needs of families with disabled older adults in the community are unique and diverse. Community health workers and social workers can develop and implement effective strategies based on the different levels of family needs to promote the health level of families with disabled older adults and improve the overall quality of life of these families.

49. The potential role of CD44+ monocytes in mediating hyperinflammatory response in bronchopulmonary dysplasia in very premature infants.

期刊: Pediatric research 发表日期: 2026-May-02 链接: PubMed

摘要

Although roles of CD44 in the genetic predisposition for bronchopulmonary dysplasia (BPD) has been recognized, the immune characteristics of CD44+ monocytes in BPD are unclear. We aimed to (1) compare the expression and function of CD44 on monocytes in BPD and non-BPD infants; (2) explore the roles of CD44 on monocytes in hyperoxia-induced inflammation. Flow cytometry assessments of the expression pattern and cytokine-secreting response upon LPS stimulation of CD44+ monocytes were conducted using peripheral blood samples from BPD infants (n = 80) and non-BPD infants (n = 106). The role of CD44 on monocytes was validated in hyperoxia exposure. CD44 expression and inflammatory cytokine secretion ability increased with postmenstrual age. The ability of CD44+ monocytes to secrete IL-6 and TNF-α was significantly greater than that of CD44-monocytes. Compared with those of non-BPD infants, the response capacity of the monocytes in BPD infants to secret IL-6 and TNF-α, especially TNF-α sourced from CD44+ intermediate monocytes, was greater upon LPS stimulation. CD44 expression significantly increased in hyperoxia, and CD44 knockdown significantly ameliorated the inflammation induced by hyperoxia. CD44+ monocytes played important roles in mediating the hyper-inflammatory response in BPD. One specific subpopulation, TNF-α+/CD44+intermediate monocytes, might be a valuable marker for identifying BPD.

1. This study revealed the key role of an immune cell subtype-CD44+ monocytes-in hyperoxia-induced bronchopulmonary dysplasia (BPD) and characterized the expression and function of CD44+ monocytes between premature infants with BPD and those without BPD. 2. CD44 was closely associated with the proinflammatory cytokine secretion capacity of monocytes. A specific subpopulation-TNF-α+/CD44+ intermediate monocytes- might serve as a valuable marker for the identification of BPD in the future. 3. Our findings added new evidence of the association between CD44+ monocytes and BPD pathogenesis, which provided new insights into the immune mechanisms for BPD.

50. Combined Preoperative Risk Score Including sCD40, Leukocytes, and BMI Predicts Pancreas-Specific Complications After Pancreatic Cancer Surgery.

期刊: Annals of surgical oncology 发表日期: 2026-May-02 链接: PubMed

摘要

Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with a 5-year survival rate of 13%. Surgical resection followed by adjuvant chemotherapy remains the only curative approach. However, complications such as postoperative pancreatic fistula (POPF) and postpancreatectomy hemorrhage (PPH) often delay or prevent further treatment. Reliable preoperative biomarkers for predicting these complications are lacking. This study investigated soluble CD40 (sCD40) as a potential predictive marker for pancreas-specific complications after pancreatoduodenectomy (PD) in patients with PDAC. Preoperative serum samples from 185 patients with PDAC undergoing pylorus-preserving pancreatoduodenectomy or a Whipple procedure were analyzed using enzyme-linked immunosorbent assay to quantify sCD40 levels. Clinical and postoperative data were systematically collected and classified. Of the 185 patients, 151 underwent pylorus-preserving PD and 34 a Whipple procedure. Clinically relevant POPF occurred in 9.7% and PPH in 7.6% of patients. Preoperative sCD40 levels were significantly lower in patients who developed POPF or PPH (P = 0.025 and P = 0.008). The association remained significant in multivariable analysis. Receiver operating characteristic analysis demonstrated an area under the curve of 0.660 for sCD40. Adding leukocytes and body mass index improved predictive performance (area under the curve 0.705 for POPF and 0.752 for PPH). Reduced preoperative sCD40 serum levels are associated with a higher risk of POPF and PPH after PD. Combining sCD40 with leukocytes and BMI may enhance preoperative risk assessment in patients with PDAC.

51. Effects of a brief aging simulation suit intervention on clinical empathy in healthcare professionals working in long-term care: a randomized controlled trial.

期刊: BMC geriatrics 发表日期: 2026-May-02 链接: PubMed

摘要

Clinical empathy refers to a healthcare professional’s ability to understand a patient’s experiences and emotions through cognitive and affective perspective taking, and to communicate that understanding through compassionate and appropriate professional behaviors. Aging simulation suits are experiential educational tools designed to replicate the sensory and physical limitations associated with aging. However, evidence regarding their effectiveness in enhancing clinical empathy among active healthcare professionals remains limited. This study aimed to evaluate the effects of an aging simulation suit on clinical empathy among healthcare professionals working in long-term care settings. A randomized controlled trial was conducted with 82 healthcare professionals from four nursing homes in Madrid and Asturias (Spain). Participants were randomly assigned to an experimental group (EG) (n=41) or a control group (CG) (n=41). Both groups received the same structured educational session on empathy and aging. The experimental group additionally participated in an immersive experience using the GERT aging simulation suit, whereas the control group did not receive the simulation component. Self-reported empathy were measured pre- and post-intervention using the Interpersonal Reactivity Index (IRI) and the Jefferson Scale of Empathy-Health Professions version (JSPE-HPS). No significant differences were found between groups in IRI scores. However, the experimental group showed significant improvements in total JSPE-HPS scores and in the subscales Perspective Taking and Compassionate Care (p < 0.05), compared with the control group. These findings suggest that the immersive intervention enhanced both cognitive and affective components of clinical empathy. The use of an aging simulation suit was associated with improvements in specific dimensions of clinical empathy among healthcare professionals working in long-term care. This educational tool offers a valuable experiential approach that enhances understanding and compassion toward older adults. However, these findings are limited to short-term, self-reported measures, and no behavioral or patient outcome data were collected. Further longitudinal studies are needed to determine the long-term sustainability of these effects and their translation into clinical practice. ClinicalTrials.gov, Unique Protocol ID: 2711201916919; ClinicalTrials.gov ID: NCT07280689. Date of registration: 10/10/2025. Retrospectively registered.

52. From economic crop to high-value product: Fermentation of chestnut protein by Lactobacillus rhamnosus ameliorates chronic inflammation via the gut microbiota-SCFAs axis.

期刊: International journal of food microbiology 发表日期: 2026-May-01 链接: PubMed

摘要

This study investigated the anti-inflammatory effect and mechanism of fermented chestnut protein (FCP), produced by Lactobacillus rhamnosus ML1-2, on high-fat diet (HFD) and lipopolysaccharide (LPS)-induced chronic inflammation in mice. The results showed that lactic acid bacteria (LAB) fermentation significantly promoted the degradation of macromolecular proteins in chestnut protein, and the release of abundant bioactive peptides, amino acids, and the functional component γ-aminobutyric acid (GABA). In mice, FCP significantly improved HFD- and LPS-induced systemic inflammation, lipid metabolic disorders, intestinal homeostasis disruption, as well as hepatic and adipose dysfunction in a dose-dependent manner. Mechanistically, FCP promoted intestinal short-chain fatty acid (SCFA) production, potentially by increasing the abundance of SCFA-producing bacteria and related metabolic pathways. These changes were putatively linked to the regulation of intestinal homeostasis and hepatic lipid metabolism through SCFA-mediated GPR/HDAC3-NF-κB and GPR-AMPK signaling. Overall, this study highlights the anti-inflammatory function of FCP, advancing sustainable plant-based fermented food development.

53. Monocrotophos-Induced Oxidative Stress Disrupts Locomotion and Metabolic Function in Drosophila melanogaster.

期刊: Journal of biochemical and molecular toxicology 发表日期: 2026-May 链接: PubMed

摘要

The study unveils potential toxic effects of a widespread organophosphate pesticide, monocrotophos, in a non-target model organism Drosophila melanogaster. Monocrotophos has been used in cotton, sugarcane, and paddy fields for many decades. Hence, a wide range of non-target organisms are get exposed to this pesticide. For the present study, five sub-lethal concentrations of monocrotophos were selected for chronic toxicity testing, which are below the determined LC50 value (0.68 µg/mL). Drosophila larvae were exposed to different sub-lethal concentrations of monocrotophos through food media from their 1st instar stage to 3rd instar stage. The present study aims to explore the reactive oxygen species generation by thioredoxin reductase activity, glutathione content, along with H2-DCFDA staining, which shows a significant amount of oxidative stress generation in both quantitative and qualitative means. MTT assay has been performed in brain tissue, which reflected a lower number of viable brain cells in treated larvae. Moreover, nuclear fragmentation in brain tissue by DAPI staining indicates the genotoxic potential of the test chemical. Acetylcholinesterase activity was found to be significantly decreased in the treated ones. Meanwhile, chronic sub-lethal exposure significantly reduced the metabolic activity, which was evident in cytosolic glucose content, glucose 6 phosphate dehydrogenase enzyme activity, and malate dehydrogenase enzyme activity. As both enzymes are closely linked with glucose metabolism, so decreased glucose level and both enzyme activity indicate altered metabolic status in cells. Poor brain health and altered metabolism status in monocrotophos-exposed larvae manifested impairment in crawling, phototaxic and embedding behavior in Drosophila. The overall study indicates monocrotophos mediated redox-imbalance, deficiency in metabolism, and compromised brain health untimely visible in poor behavioral responses. As this pesticide is able to contaminate different environmental compartments thus these hazardous effects will inevitably impact many non-target organisms. Observations of the present study can also be extrapolated to other non-target organisms as D. melanogaster shares significant homology with higher vertebrates.

54. In Vitro Studies on Induction of Ferroptosis Upon Low-level Exposure of Bisphenol A on Rat Erythrocytes.

期刊: Journal of biochemical and molecular toxicology 发表日期: 2026-May 链接: PubMed

摘要

Bisphenol A (BPA), is a xenoestrogen used in plastic manufacturing companies. Some countries are limiting the use of BPA. The widespread use of BPA has resulted in its accumulation in the natural environment. This compound is extensively utilised in various industrial products and is linked to harmful effects on both wildlife and human health. In recent years, extensive research has focused on ferroptosis-an iron-dependent form of programmed cell death characterised by lipid peroxidation. Also, several studies highlight the involvement of ferroptosis in mediating the toxic effects of environmental pollutants. This study aimed to deepen our understanding of BPA-induced ferroptosis by investing its impact on the antioxidant defence system, the structural integrity (as indicated by the rate of haemolysis), and the functionality of red blood cells. The research focused on evaluating the toxic effects of BPA through biochemical and haematological analyses conducted on RBCs of rats. To evaluate the involvement of ferroptotic cell death in BPA-induced toxicity, ferroptosis inducer RSL-3 and ferroptosis inhibitor Ferrostatin were used in the study either alone or in co-administration with highest concentration of BPA. The results showed that compared to the vehicle treated control group, after acute exposure of RBCs to BPA showed a notable decrease in Hb (haemoglobin) content and number of red blood cells. The ferroptotic markers viz. lipid peroxidation, GPx4 levels and ACSL4 activity were observed across all treatment groups. The results showed the possible involvement of ferroptosis on all these markers which were confirmed in the presence of ferroptosis inducer and inhibitor. Also, oxidative and nitrosative stress levels increased in a concentration-dependent manner of BPA. Furthermore, the activity of two important antioxidant enzymes; superoxide dismutase, and catalase lowered notably after BPA treatment. Results also showed significant morphological alterations, and increased membrane damage of RBC upon of BPA treatment. The study concludes that BPA exhibits oxidative stress, which may be one of the mechanisms causing RBC toxicity. The present study indicated that ferroptosis plays a key role in the progression of BPA-induced RBC toxicity; thus it can become a novel target in treatment of haemolysis.

55. MatchY: A software implementation of pedigree-based calculation of Y-STR match probabilities.

期刊: Forensic science international. Genetics 发表日期: 2026-Apr-27 链接: PubMed

摘要

Y-STRs are used in forensic genetics to investigate male trace material in cases where no useful autosomal STR profiles can be established. While non-matching suspects can be safely excluded from trace donorship this way, interpreting Y-STR haplotype matches is less straightforward. Equating the corresponding Y-STR match probabilities to haplotype frequencies estimated from population databases is not only common practice, but is also recommended by the International Society for Forensic Genetics. However, this approach ignores that population databases, in principle, cannot be representative of all plausible alternative suspects in each and every case. Therefore, we previously introduced a novel mathematical framework for calculating Y-STR match probabilities drawing upon the suspect’s male pedigree, thereby obviating the use of haplotype frequency estimates from population databases for this purpose. Here, we present the implementation of this framework into a publicly available software tool, named MatchY. Expanding the original approach in various ways, the tool can handle any number of single or multi-copy Y-STRs with known mutation rates and allowing both one-step and two-step mutations. MatchY can calculate match probabilities for pedigrees of any size and complexity based upon the haplotype information of its typed members, while simulating haplotypes of untyped ones. In addition to considering all plausible trace donor candidates within the pedigree, the tool can also consider a hypothetical, most closely related candidate from outside the pedigree. The performance of MatchY has been tested using various marker sets and example pedigrees. Together, these features make MatchY a practical and formally correct tool for the interpretation of Y-STR matches by calculating Y-STR match probabilities based on the suspect’s male pedigree.

56. Isolation and characterization of a therapeutic lytic phage cocktail against mastitis-associated Enterococcus faecalis with antibiofilm activity and in vivo efficacy.

期刊: Veterinary microbiology 发表日期: 2026-Apr-24 链接: PubMed

摘要

Antimicrobial-resistant (AMR) mastitis-associated Enterococcus faecalis and Enterococcus faecium threaten dairy production, animal welfare, and public health due to economic losses and zoonotic risk. Environmental mastitis is increasingly linked to E. faecalis, which is frequently detected in milk and animal-derived products. Three novel lytic bacteriophages-vB_Ef3_HMKU_24 (vB_Ef3), vB_Ef5_HMKU_24 (vB_Ef5), and vB_Ef32_HMKU_24 (vB_Ef32)-were isolated from wastewater in Türkiye and characterized for host range, stability, replication kinetics, antibiofilm activity, in vivo efficacy (Galleria mellonella), and genomic features. The phages vB_Ef3, vB_Ef5, and vB_Ef32 exhibited strong and specific lytic activity against E. faecalis (up to 69.1% individually; 72.7% as a cocktail) with no activity against other species. They remained active across pH 4-10 and up to 70 °C. Optimal MOIs were 10 (vB_Ef3), 0.1 (vB_Ef5), and 0.001 (vB_Ef32). vB_Ef5 and vB_Ef32 fully suppressed bacterial growth for 24 h, whereas vB_Ef3 caused transient inhibition. Burst sizes were ∼2019, ∼153, and ∼287 PFU/cell for vB_Ef3, vB_Ef5, and vB_Ef32, respectively. All phages significantly inhibited and eradicated biofilms; vB_Ef5 was the most effective single agent (71% inhibition, 68% eradication), while the cocktail achieved the highest activity (82% and 73%). In the G. mellonella infection model, phage treatment improved larval survival, with the cocktail reaching ∼90% and showing no toxicity. Genomic analyses (40.3-58.6 kb; 34.9-39.5% GC; 78-118 ORFs) confirmed strictly lytic phages encoding endolysins and lacking virulence or AMR genes, classified within the Herelleviridae. Collectively, these findings demonstrate that the combined use of vB_Ef3, vB_Ef5, and vB_Ef32 represents a safe, stable, and highly effective phage cocktail with strong potential as a precision therapeutic strategy against multidrug-resistant E. faecalis-associated bovine mastitis.

57. Successful Management of a Huge Pulmonary Hydatid Cyst in a Young Child: A Case Report.

期刊: Journal of mother and child 发表日期: 2026-Jan-01 链接: PubMed

摘要

Hydatid cyst disease is a parasitic disease induced by Echinococcus granulosus, which is still endemic in northern African countries. We report the case of a late-discovered pulmonary hydatid cyst in a four-year-old boy revealed by recent dyspnoea. The chest X-ray showed a complete white-out of the left hemithorax with mediastinal deviation, and the thoracoabdominal CT scan showed a giant pulmonary hydatid cyst encompassing the entire left lung associated with a hepatic cyst. An emergent superior pulmonary lobe resection was performed under deep general anaesthesia and selective intubation to prevent contralateral lung inundation. The evolution was favourable postoperatively.